Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 1998 Current Population Survey

This Issue Brief provides summary
data on the insured and uninsured populations in the nation and
in each state. It discusses the characteristics most closely
related to individuals' health insurance status. Based on EBRI
analysis of the March 1998 Current Population Survey, it
represents 1997 datathe most recent data available.

In 1997, private or public health
insurance, or both, covered 81.7 percent of Americans (193.1
million) at some point. Seventy-one percent of the nonelderly
population had private insurance, 64.2 percent through an
employment-based plan. Almost 15 percent of the nonelderly had
public health insurance.

In 1997, 18.3 percent of the nonelderly
population was uninsured, compared with 14.8 percent a decade
earlier, in 1987. The percentage of uninsured Americans has been
increasing since at least 1987. While the increase in the
uninsured between 1987 and 1993 can be attributed to the erosion
of employment-based health benefits, the portion of Americans
covered by employment-based health insurance increased between
1993 (63.5 percent) and 1997 (64.2 percent).

The decline in public sources of
health insurance would mostly explain the recent increase in the
uninsured population. For example, between 1994 and 1996 the
percentage of nonelderly Americans covered by CHAMPUS/CHAMPVA
declined from 3.8 percent to 2.9 percent, in large part due to
downsizing in the military. Similarly, between 1996 and 1997, the
percentage of nonelderly Americans covered by Medicaid (the
federal-state insurance program for the poor) declined from 12.1
percent to 11.0 percent as people left welfare for the private
sector. This follows a decline in Medicaid participation between
1995 and 1996.

Between 1996 and 1997, the percentage of
nonelderly Americans without health insurance coverage increased
from 17.7 percent to 18.3 percent. Further examination indicates
that adults ages 1864 accounted for almost all of this
increase. In 1996, 14.8 percent of children and 18.9 percent of
persons ages 1864 were uninsured, compared with 15.0
percent of children and 19.7 percent of persons ages 1864
in 1997. The decline in Medicaid coverage among nonworking and
working adults appears to account for the overall increase in the
uninsured.

Employment and income play a dominant
role in determining an individual's likelihood of having health
insurance. In addition, age, gender, firm size, hours of work,
and industry are all important determinants of an individual's
likelihood of having coverage; however, these variables are also
closely linked to employment status and income. Some of the
widest variations involve factors that are not always examined in
traditional demographic assessments, such as citizenship.
However, variations by race, ethnicity, and citizenship are also
closely linked to employment status and income.